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N156
N156 – Occipital artery
OHIP Otolaryngology Code — NEUROLOGICAL SURGICAL PROCEDURES · Schedule of Benefits
A neurological surgical procedure involving an extracranial-intracranial microvascular anastomosis of the occipital artery. This is a major cranial surgery. Payment for the surgeon (suffix A) is a set fee, while payment for the assistant (suffix B) and anaesthetist (suffix C) is calculated using basic and time units. See - for surgical assistant and - for anaesthetist fee calculations. Add-on code E904 is payable for work in the posterior fossa.
When to Use
- Use N156 for extracranial-intracranial microvascular bypass procedures specifically involving the occipital artery as the donor vessel.
- Use N156 in conjunction with E904 when the surgical approach or the target site of the anastomosis is located within the posterior fossa.
Common Pitfalls
- Failure to document the specific Injury Severity Score (ISS) in the medical record when attempting to claim the E420 trauma premium.
- Attempting to bill for a second surgical assistant without prior authorization, as N156 is not on the pre-approved list for multiple assistants.
- Incorrectly applying E904 to procedures that do not involve the posterior fossa, which will lead to claim rejection or recovery during audit.
Billing Tips
- Ensure the surgical report explicitly details the posterior fossa involvement to justify the E904 add-on code.
- When billing for the assistant (suffix B) or anaesthetist (suffix C) for multiple procedures, ensure the basic units are derived solely from the major procedure (N156) to avoid billing errors.
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